TheMelanomaCenter Categories

Senior Editor’s Choice!

Our Senior Editor loves this book! It is a very insightful look at the history of cancer treatment, going back to Egyptian times and continuing with profiles of patients and noteworthy physicians. All the things we take for granted now in the treatment of cancer: chemotherapy, surgery, radiation, etc., are all traced back to their roots!

Here is the schedule of melanoma-related events for ASCO this year. It is possible that I have missed some Phase I presentations with melanoma patients included.

Friday June 1: No sessions

Saturday, June 2:

8 am “New Options, New Questions: How to Select and Sequence Therapies for Metastatic Melanoma”

Three talks, by Dr. Mike Atkins, Dr. Keith Flaherty, and Dr. Jeff Sosman, all dealing with the prickly and unresolved (at least by any hard data) questions about the sequence and timing of immunotherapy and BRAF inhibitor therapy in patients with metastatic melanoma. I have talked to a lot of people about this issue and there are emerging thoughts on these issues, although they are all colored by some level of personal/institutional bias and experience. Also, what about patients who are BRAF wild-type (no mutation), who cannot receive a BRAF inhibitor which only treats the mutated enzymes? This will also be discussed. A great beginning to ASCO!

1:15 pm – 5:15 pm, Melanoma “discussed” posters

These are the posters that are felt to be important enough to warrant separate discussion of their findings. The majority of the posters describe early findings in various targeted therapies and should be very interesting in helping to identify the next generation of targeted therapies to investigate in Phase III studies.

Sunday June 3:

8 am -12 noon General poster session

These posters describe a wide variety of trial results, many looking at side effects of newly approved drugs like ipilimumab, genetic testing for melanoma, and other new agents. At ASCO, the general poster session often includes very relevant studies and information, beyond that seen at most other medical meeting poster sessions. It is always well attended.

Monday June 4:

8 am -11 am Oral Abstract session

These are generally the strongest (non-plenary) studies at ASCO. This year, 9 different studies are being presented. The headline study is being presented first, a Phase III randomized comparison (“BREAK-3″) of the GSK BRAF inhibitor, dabrafenib, vs DTIC. Results of this abstract will not be released until that AM. Other papers look at the intracranial response of melanoma brain metastases to dabrafenib therapy, updated survival stats from the Zelboraf Phase III trial presented last year at the Plenary session, and an analysis of the molecular escape mechanisms that arise to overcome BRAF inhibition. There are then three studies looking at adjuvant therapy with interferon for cutaneous and mucosal melanoma, including a trial comparing interferon to “biochemotherapy” with IL2, cisplatin, vinblastine and DTIC, which was a popular regimen about 10-20 years ago. The last two studies look at immunotherapy with anti-PD-1 antibody, which may be the NEXT great immunotherapy, and also results from the expanded access program of higher dose (10 mg/kg) ipilimumab.

3 pm – 4:30 pm Mutated melanoma: the Role for MEK inhibitors

The MEK enzyme is the next one downstream from BRAF in a cell growth and division pathway. Combining MEK with BRAF inhibitors may be better than either one individually. This session looks at MEK inhibitors, alone or in combination with BRAF inhibitors, in patients with metastatic melanoma. The third paper also looks at patients with NRAS mutations, which are about half as common as BRAF mutations but will likely define another subgroup of patients’ treatments. This should be a very interesting session.

There are some other sessions in the Developmental Therapeutics (i.e. Phase I) section that will be relevant to melanoma, focused on ipilimumab, anti-PD-1 immunotherapy and related toxicities.